STRESS UNINARY INCONTINENCE

Stress Urinary Incontinence is the leaking or urine in situations where the bladder is under pressure. It happens to women of all ages, those active and inactive and those who have had children and those who haven’t.

In the most basic terms, leakage occurs when the pressures coming from the above the bladder are too high e.g. increased abdominal pressure (when you sneeze or cough). Or maybe a tight thorax, rib cage or abdominals could be contributing to increased pressure, which may need to be released.

Leakage can also occur when the supporting muscles and structures from below the bladder are not high enough. The pelvic floor and surrounding connective tissue hold the bladder up during a instance of increased pressure e.g. a cough, if these structures are weak then the bladder can drop and leakage can occur.

When treating your incontinence it is important to assess both the components above and below the bladder to effectively address the issue.

How do we assess?

  • The gold standard for assessing pelvic floor status is an internal examination, we look at strength, endurance, coordination and tension of the pelvic floor. We can also assess how much the bladder drops and moves
  • Ultrasound
  • Assessment of the rest of the body to find other contributors

Treatment may involve:

  • Pelvic floor conditioning with strength work and coordination
  • Treating the ribs, abdominals, thorax
  • Assess breathing patterns and how this effects the pressures in the abdomen
  • Advice on exercise and modifications you can make
  • Advice on lifestyle factors such as weight, diet, bladder and bowel emptying (how to avoid straining)
  • Education on pessaries and how they can help. A pessary is a medical device which is inserted into the vagina to help hold organs up. Correct sizing and proper education on how to insert, remove and care for a pessary is important to its effectiveness
  • Referring on to the appropriate specialist if required e.g. gynaecologists, urogynaecologist, colorectal surgeons